A qualitative comparison of DSM depression criteria to language used by older church-going African-Americans
A qualitative comparison of DSM depression criteria to language used by older church-going African-Americans
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DOI：
10.1080/13607863.2017.1337717
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发表时间：
2018-01-01
影响因子：
3.4
通讯作者：
Kales, Helen C.
中科院分区：
文献类型：
--
作者：
Akinyemi, Esther;Watkins, Daphne C.;Kales, Helen C.
目的：老年抑郁症与严重的痛苦、残疾、自杀风险和健康相关的生活质量下降有关。根据《精神疾病诊断与统计手册》第四版（DSM-IV），抑郁症的诊断是从一系列症状中得出的，这些症状可能被不同的人描述得不同。例如，DSM的语言可能不足以捕捉这些症状在某些人群中，如非洲裔美国人，其抑郁症误诊率是high.Methods：本研究报告的结果从教会为基础的，定性研究与老年非洲裔美国人（n = 50）关于他们使用的语言时，讨论抑郁症和抑郁症的治疗，以及如何这相比，DSM-IV抑郁症的标准。与非裔美国男性和女性焦点小组参与者进行深入讨论的内容分析，使他们对描述抑郁症的语言有了更深入的理解。然后将这种语言映射到DSM-IV抑郁标准。结果：虽然焦点小组参与者使用的一些词很好地映射到DSM-IV标准，但有些语言没有映射好，例如描述易怒，消极思维过程，绝望，孤独，失控，无助和社会孤立的语言。焦点小组的设置提供了对年长的、经常去教堂的非裔美国人描述抑郁症的语言的洞察。影响包括使用定性数据的优势，以帮助通知与老年非裔美国人的临床遭遇。
Objective: Depression in late life is associated with substantial suffering, disability, suicide risk, and decreased health-related quality of life. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), a depression diagnosis is derived from a constellation of symptoms that may be described differently by different people. For example, the DSM language may be inadequate in capturing these symptoms in certain populations such as African-Americans, whose rates of depression misdiagnosis is high.Methods: This study reports the findings from a church-based, qualitative study with older African-Americans (n = 50) regarding the language they use when discussing depression and depression treatment, and how this compares to the DSM-IV depression criteria. Content analyses of the in-depth discussions with African-American male and female focus group participants resulted in a deeper understanding of the language they used to describe depression. This language was then mapped onto the DSM-IV depression criteria.Results: While some words used by the focus group participants mapped well onto the DSM-IV criteria, some of the language did not map well, such as language describing irritability, negative thought processes, hopelessness, loneliness, loss of control, helplessness, and social isolation.Conclusions: The focus group setting provided insight to the language used by older, church-going African-Americans to describe depression. Implications include the advantages of using qualitative data to help inform clinical encounters with older African-Americans.